Make every week 'Nurses Week:' 5 ways to recognize nurses year … · 2019-06-19 · 1) Based on...

Make every week 'Nurses Week:'

5 ways to recognize nurses year-round

Nursing Executive Center

Karl Frederick Meyer Whitemarsh

Consultant

[email protected]

6

©2019 Advisory Board • advisory.com • 29661A


Recognition

for Everyone

1. On-the-Spot

Recognition

Cards

Best practices to recognize nurses year-round

Recognition

from Managers

2. Manager’s

Frontline

Recognition Kit

3. Principled

Recognition

Triggers

Recognition

from Executives

4. Executive’s

Frontline

Recognition

Routine

Recognition

for Preceptors

5. Preceptor

Recognition

Selection

7


Source: Tanner OC, “Improving staff engagement: a practical toolkit,” November 2009,

http://d26f1zbt4c3e98.cloudfront.net/wp-content/uploads/sites/2/2013/06/employee-

engagement-research.pdf; “Workforce Mood Tracker™ September 2011 Report,” Globoforce,

http://go.globoforce.com/rs/globoforce/images/WorkforceMoodTracker_September2011_FINAL

_ONLINE.PDF; Advisory Board interviews and analysis.

The Ripple Effect of Recognition

Driving the Other Drivers

“‘Showing appreciation’ is a secondary

driver of engagement and also a driver of

every one of the other drivers…

Regardless of where an organisation

scored in any of the [other] drivers, if they

also ‘showed appreciation,’ their

engagement scores increased

significantly…

In other words, where appreciation was

present in a culture, employees felt there

was more trust, better communication,

more pride in the workplace, and a greater

sense of opportunity and well-being.”

Michelle Smith

O.C. Tanner Company

WeakPerformance on

EngagementDriver

Weak Driver PlusAppreciation

73% Increase

Showing Appreciation Can Overcome Weaknesses in Other Areas

Impact of Showing Appreciation on

Respondents’ Perceptions of Other

Engagement Drivers

46

8


Facilitate Opportunities to Routinely Show Appreciation

Source: Advisory Board interviews and analysis.

Ensure Staff At All Levels Feel Valued

• Routine

• Involves Everyone

• Visible

Frequency: Regular Quality: Meaningful

• Specific

• Personal

• Timely

Root Causes for Why Formal Recognition Efforts Are Insufficient

Opportunity: Embed Meaningful Recognition into Day-to-Day Operations

Generic and Impersonal

Rewards and messages

not personally meaningful

for individuals and teams

Reserved for Elite

Formal recognition

schemes only used

once-in-awhile for

exemplary individuals

47

9


The Solvable Challenge

Recognition Under-Values Professional Impact


Dear Rebecca,

You are a Gold Star nurse. Thank you

for your commitment to excellence!

Sincerely,Anna

Dear Rebecca,

Thank you for sitting down

with Mr. Jones last night after

your shift ended. I know how

much it meant to him, having

someone there while he was

waiting to go into surgery. He

was nervous, and you went out

of your way to make him as

comfortable as possible.

Your work truly exemplified our

commitment to excellence and

patient-centered care.

Sincerely,

Anna

It’s Easy to Tell the Difference

10


Defining “Meaningful” Professional Recognition


Key Elements of Meaningful Recognition

Delivered Promptly

Following Achievement

Linked to Specific

Accomplishments

Provided by Someone

Professionally Important

©2019 Advisory Board

11On-the-Spot Recognition Cards

Source: Mackenzie Health, Richmond Hill, Ontario,

Canada; Advisory Board interviews and analysis.

Recognising Excellence In the Moment

To:

I want you to know that I really

appreciated it when you…

I’m recognising you for demonstrating

the following Step Up behaviour:

From:

Took time to listen to my concerns about the side effects of the medication that the doctor prescribed for me.

Nurse Miller

Fiona Smith

Patient Experience

Card template prompts for

specific actions, behaviours of

recognised nurse

“On the Spot Kudos” Recognition Cards

Card is handwritten and

delivered directly to nurse

in-the-moment

“Kudos-

worthy”

behaviours

determined by

staff through

focus groups,

committees

Individuals Who Can Utilise “On the Spot Kudos” Cards:

Peers Patients Families Managers


12

Recognising Excellence In the Moment (cont.)

Case in Brief: Mackenzie Health

• 506-bed hospital located in Richmond Hill, Canada with 2,300 staff

• Implemented “Kudos Awards” in summer 2013 as a tactic to address

opportunity for improvement in scores in recognition section of staff

engagement survey

• Used focus groups and committees to define “kudos-worthy” behaviours

• Recognition cards placed around the hospital so frontline staff, managers,

and patients can provide staff members with immediate recognition

• Individual kudos not formally tracked by the organisation





Equipping Staff to Deliver Meaningful Feedback

For continued list of Kudos example behaviours,

see appendix for Energising the Nursing Workforce

“Step Up: It Starts with Me”

Behaviour Domains

Representative

Behaviours

Patient and Family Experience:

Respecting the dignity and

confidentiality of patients and their

families

Customising

communication with

patients and family

members

Quality and Safety:

Ensuring that quality care is provided

and safety is maintained

Suggesting ways to

achieve improvements

and efficiencies

Communication:

Communicating clearly with patients

and their families

Asking questions to

clarify information

before taking action

Professionalism:

Maintaining a calm, pleasant, and

professional demeanour

Identifying and seizing

every opportunity to

help others

IMA

GE

CR

ED

IT:

MA

CK

EN

ZIE

HE

ALT

H




14

Building a Comprehensive Recognition Program

On-the-Spot Recognition Cards

On the Spot Kudos Keep it Up Kudos President’s Kudos

Casual and immediate way

to recognise an individual

or team who demonstrates

one of the behaviours in

their day-to-day tasks.

Bi-annual recognition of 10

individuals and 2 teams

who do something that

creates lasting impact in

one or more of the target

behaviour areas.

Annual award for 4

individuals and 1 team

who’s exceptional ideas

and actions demonstrate

the behaviours and

advance organisational

strategy.

Immediate Bi-Annual Annual

Components of Mackenzie Health’s Recognition Scheme





Generating Enthusiasm Through Structured Roll-Out

Manager Guidance for Kudos Roll-Out to Frontline

Huddle 1

Kudos Program Launch

• Introduction to the

Kudos behaviours

• Encourage staff to

demonstrate the

behaviours

themselves and

recognise the

behaviours in others

Huddle 2

Building Awareness

• Introduction to the

three different types of

recognition:

• On the Spot

• Keep it Up

• President’s

Card

Huddle 3

Encouraging Participation

• Ask staff to identify

individuals or teams

who are Kudos-worthy

• Recognise a staff

member with an On the

Spot Kudos card

• Leaders Guide

• Kudos Brochure

• Kudos Poster

Manager Toolkit Components

• Kudos Program Memo

• Huddle Scripting



• Kudos Card and

Nomination form



1) Based on Mackenzie Health’s internal staff engagement data.

2) Canadian dollars.

Engagement Efforts Bearing Fruit

Spring Year 1 Fall Year 3

Staff Engagement at Mackenzie Health

20%

Increase

Inclusive Recognition

“Part of the strength of this program is its inclusive nature. …It’s a great way to validate all roles

and contributors and to inspire everyone to ‘step up.’”

Kudos Implemented

Number of

‘Kudos on the Spot’

cards printed

since program launch

Annual Printing Cost

+2000”

$1,500 CAN2

Staff Member




17


Create a Culture of Appreciation

Key Elements to Create a Culture of Appreciation

Make Recognition

More Regular

Create opportunities for recognition

that are:

Routine

Achievable

Visible

2

Improve the quality of recognition by

making it:

Personal

Timely

Specific

Embed More Meaning

Into Recognition

1

From Insight to Action: Visit Tools to create a culture of recognition

Embed meaningful recognition into frontline routine with our tool suite

on creating a culture of appreciation. Found online at advisory.com


18


Recognition

for Everyone

1. On-the-Spot

Recognition

Cards


Recognition

from Managers

2. Manager’s

Frontline

Recognition Kit

3. Principled

Recognition

Triggers

Recognition

from Executives

4. Executive’s

Frontline

Recognition

Routine

Recognition

for Preceptors

5. Preceptor

Recognition

Selection


19

Timely, Meaningful Recognition Not Easy to Achieve

19


Manager’s Frontline Recognition Kit

Can’t find nurse’s

home address

Manager decides to

recognize a nurse’s

excellent work with

a hand-written note

Manager out

of note cards

Representative Challenges to Manager Sending a Note Home

Note never gets written;

opportunity for meaningful

recognition missed

Emergency

on the unit


20

Placing Recognition Tools Within Easy Reach

Source: St. Joseph’s Hospital Breese, Breese, IL; Advisory Board interviews and analysis.


Key Elements of St. Joseph’s “Mission Box”

• Contains note

cards, envelopes,

addresses,

and stamps

• Additional cards

available in

managers’

break room

• Includes additional

activities to help

managers, staff

connect with mission

and values, including

an exercise to

encourage staff

to verbally

recognize peers

demonstrating values

• Managers add

new unit staff’s

addresses to box

as they join the unit

• Leaders revisit box

every two months

and ensure all staff

are represented

Contains All

Needed Supplies

Updated Frequently Provides Additional

Recognition Activities

Pre-Assembled

for Managers

• Assembled every

two months by two

nursing directors

• Delivered to

managers in a

management

meeting


21

Source: St. Joseph’s Hospital Breese, Breese, IL; Advisory Board interviews and analysis.

Placing Recognition Tools Within Easy Reach

Case in Brief: St. Joseph’s Hospital Breese

• 69-bed hospital located in Breese, Illinois

• Mission Box introduced in September 2012 to facilitate managers delivering

personal recognition to frontline staff who demonstrate exceptional commitment

to organization’s values

• Mission Box contains note cards and envelopes for managers to send notes to

staff members’ homes, stamps, home addresses of unit staff; activities for

managers highlighting opportunities to help staff connect to organizational values,

recognize staff for demonstrating those values

• Each manager stores the box in his or her office; the box is a plastic container,

approximately 13 inches wide by 8 inches long by 5 inches deep

• Box replaced by nursing leaders every two months with new activities to reflect

a different organizational value: care, joy, respect, competence



22

Clearly Indicating What–and When–to Reward


Principled Recognition Triggers

Principled Recognition Trigger Process

Manager Sets Trigger for

Recognition

Staff

Meet Goal

Manager Delivers

Pre-Determined

Recognition


23

Rewarding Unit Outcomes Based on Clear Standards

Four Levels of Achievement at Toledo Hospital

Source: The Toledo Hospital, Toledo, OH; Instilling Frontline Accountability,

2011; Advisory Board interviews and analysis.


1) 1 Questions include “Overall Rating of Hospital,” “Would you recommend

this hospital to your friends and family?”, “During this hospital stay, how

often did nurses treat you with courtesy and respect?” and “During this

hospital stay, how often was your pain well controlled?”

Quarterly Unit Recognition Awards

Level Criteria Reward

PlatinumPerformance on four targeted HCAHPS

questions1 above 90th percentile

Unit banner,

trophy of candy

GoldPerformance on four targeted HCAHPS

questions above 75th percentileUnit banner

Silver

Performance on question “Would you

recommend this hospital to your friends and

family?” trends upward for consecutive three

quarters, with last quarter above median

Unit banner

BronzePerformance on four targeted HCAHPS

questions above 50th percentileUnit banner


24

Rewarding Unit Outcomes Based on Clear Standards

Case in Brief: The Toledo Hospital

• 794-bed teaching hospital located in Toledo, Ohio; part of the ProMedica System

• To maintain high HCAHPS scores, units rewarded quarterly for performance;

clear reward criteria posted next to unit dashboards to ensure visibility to all staff

• Rewards relatively simple, but prominent recognition engenders competition,

spurs improvement

Source: The Toledo Hospital, Toledo, OH; Instilling Frontline Accountability,

2011; Advisory Board interviews and analysis.



25

Recognition Triggers Implementation Guidance



Manager Guidance for Implementing Recognition Triggers

Choose one to three key metrics your team has an opportunity to improve

Set targets for each metric that are reasonable for your team to achieve in

the near term as well as a timeframe for achieving targets; targets need

not be immediately within reach, but should be attainable within

approximately three months

Brainstorm reward options that will please majority of staff, allow team to

vote on one; alternately, let team provide suggestions and consolidate into

short list for vote

Deliver rewards promptly after target achieved; to accommodate this,

begin to make arrangements before timeframe actually closes

Ensure reward levels are differentiated if multiple metrics are chosen and

targets achieved

Regularly evaluate performance; replace any metrics for which team

meets target more than three consecutive measurement periods

Consider introducing individual-level metrics after team becomes

comfortable with team-level metrics; ensure that combined number of

team and individual metrics does not exceed three


26

Not Just a Manager Issue

Recognition by Executives Falling Short

Source: Advisory Board Survey Solutions’ Employee Engagement Initiative

National Database; Advisory Board interviews and analysis.


1) Responding “agree” or “strongly agree.”

49%

Median percentage of staff agreeing1

with “My organization recognizes

employees for excellent work.”

46%Median percentage of staff agreeing1

with “Executives at my organization

respect the contributions of my

unit/department.”

55%Median percentage of staff agreeing1

with “I receive regular feedback from

my manager on my performance.”


27

Principled Recognition Triggers for Executives

Celebrating Specialty Certification at the Valley Hospital

Source: The Valley Hospital, Ridgewood, NJ; Advisory Board interviews and analysis.


IMA

GE

CR

ED

IT: T

HE

VA

LE

Y H

OS

PIT

AL.


28

Source: The Valley Hospital, Ridgewood, NJ; Advisory Board interviews and analysis.

Principled Recognition Triggers for Executives

Case in Brief: The Valley Hospital

• 451-bed hospital located in Ridgewood, New Jersey

• CNO set goal to increase percentage of RNs with specialty certification

• When staff member attains certification, CNO alerted by unit manager and APN

assigned to monitor certification progress; CNO then visits RN’s unit to publicly

congratulate RN in person, brings balloons and large, humorous check

• Staff members enjoy helping recognize their peers; participation in peers’

celebrations motivates RNs to seek certification themselves


29

The Executive’s Frontline Recognition Must-Haves



Specialty

Certification

Advanced

Degree

State or

National Award

Action with

House-Wide Impact

Published

Research

Frontline Achievements Executives Should Recognize Personally


30


Recognition

for Everyone

1. On-the-Spot

Recognition

Cards


Recognition

from Managers

2. Manager’s

Frontline

Recognition Kit

3. Principled

Recognition

Triggers

Recognition

from Executives

4. Executive’s

Frontline

Recognition

Routine

Recognition

for Preceptors

5. Preceptor

Recognition

Selection


31

Hardwiring Recognition at the Executive Level

Source: WellSpan Gettysburg Hospital, Gettysburg, PA; Advisory Board interviews and analysis.

Executive’s Frontline Recognition Routine

Sample “Friday Feedback” Recognition

PROBLEM SOLVERS AT WORK—Thanks to Henry Donnelly in CCU

who happened to notice that the

valuables bags we use here are

costing us $1.34 each and found that

York Hospital has bags purchased at

a much lower cost: $0.25. We are now

stocking the less costly bag—thanks for

the good catch, Henry! It all adds

up to taking cost out of our system

that is critical to our overall efforts.

CONGRATULATIONS—To

Gettysburg Hospital Housekeeping

Team. Not only is it Housekeeping

week and we want to say thank you,

but this team created significant

improvement in our cleanliness

scores this past year, gaining a 5.9

point improvement, the highest of all

our inpatient units. Great work to a

very focused team!


32


Hardwiring Recognition at the Executive Level

Case in Brief: WellSpan Gettysburg Hospital

• 74-bed hospital located in Gettysburg, Pennsylvania; part of WellSpan Health

• President sends weekly “Friday Feedback” email with help of administrative

assistant; purpose to share hospital news and organizational changes and

publicly recognize staff

• Emails recognize at least one individual or group each week; staff from any

department and at any level eligible for recognition

• Recognition based on patient and family feedback, impact on financial

stewardship or organization’s strategic priorities



33

Identifying Staff Worthy of Recognition



Evaluate Achievements

Against Criteria

Develop List of Likely

Sources of Candidates

Possible sources include:

• Daily huddle reports

• Patient feedback to the

President’s Office

• Nominations from

managers, colleagues

Staff achievements

evaluated for impact on:

• Strategic priorities

• Safety and quality

• Patient and family

experience

Process for Selecting Staff for Weekly Recognition


34


Recognition

for Everyone

1. On-the-Spot

Recognition

Cards


Recognition

from Managers

2. Manager’s

Frontline

Recognition Kit

3. Principled

Recognition

Triggers

Recognition

from Executives

4. Executive’s

Frontline

Recognition

Routine

Recognition

for Preceptors

5. Preceptor

Recognition

Selection

© 2019 Advisory Board • All rights reserved • advisory.com • WF785739-c 1/24

35

Preceptors play crucial role in new nurse development

A different-in-kind ‘experience’ shortage

Preceptor Recognition Selection


The “experience-complexity gap”

Care complexity

Nursing workforce

experience

/

http://www.advisory.com/

© 2019 Advisory Board • All rights reserved • advisory.com

36

Maximize the Impact of Preceptor Recognition

Preceptor Recognition Selection


Tool 7: Select the right recognition

tactics for your preceptors

• Goal of tool is to help you create a

meaningful preceptor recognition strategy

• Recommended even for organizations

that already recognize preceptors to help

refine or improve strategy

Executive Strategies:

1. Evaluate your preceptor program

2. Focus on new preceptor development

3. Reinforce skills with ongoing preceptor support

4. Maximize the impact of preceptor recognition

5. Raise the bar on preceptor recruitment

http://www.advisory.com/


37


Recognition

for Everyone

1. On-the-Spot

Recognition

Cards


Recognition

from Managers

2. Manager’s

Frontline

Recognition Kit

3. Principled

Recognition

Triggers

Recognition

from Executives

4. Executive’s

Frontline

Recognition

Routine

Recognition

for Preceptors

5. Preceptor

Recognition

Selection

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Make every week 'Nurses Week:' 5 ways to recognize nurses year … · 2019-06-19 · 1) Based on...

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